Erica Joyner – Page 33 – In The States

Illinois

HB711, sponsored by Representative Gregory Harris (D), was signed by Governor JB Pritzker (D) on August 19, 2021. The measure will take effect on January 1, 2022 and applies to all managed care organizations and provides requirements concerning disclosure and review of prior authorization requirements, denial of claims or coverage by a utilization review program, and the implementation of prior authorization requirements or restrictions.

Also in Illinois, HB1745, sponsored by Representative Gregory Harris (D), was signed by Governor JB Pritzker (D) on August 19, 2021. The measure will take effect on January 1, 2023 and requires every health insurance carrier which provides coverage for prescription drugs to ensure that at least a certain percent of an individual’s healthcare plan must apply a flat-dollar copayment structure to their entire drug benefit.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Erica Joyner2021-10-01T12:27:32-04:00October 1, 2021|Illinois|

Iowa

For the latest information and updates impacting Iowa’s enrolled vaccine providers, please visit the Iowa Dept. of Public Health (IDPH) COVID-19 Vaccine Providers web page, and click on the most recent version of the “ Vaccine Information Brief”. IDPH posted a NEW Vaccine Information Brief (9.27.2021). Note: changes to the document are highlighted in yellow. Also, for all Iowa-enrolled vaccine providers, a weekly listserv message will be sent to emails on record; this message will include the “Vaccine Information Brief”, as appropriate.

Also in Iowa, the Department of Human Services issued INFORMATIONAL LETTER NO. 2266-MC-FFS-CVD, containing information and updates regarding the authorization of an additional dose of COVID-19 vaccine following an initial 2-dose primary series of mRNA COVID-19 vaccine for certain immunocompromised individuals. See informational letter for details about billing and coding for administration fees.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Erica Joyner2021-10-01T12:26:36-04:00October 1, 2021|Iowa|

Louisiana

Both the Pharmacy Benefit Manager Advisory Council and the Prescription Drug Monitoring Program Advisory Committee will be holding their quarterly meetings in Baton Rouge on Wednesday, October 13.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Erica Joyner2021-10-01T12:25:34-04:00October 1, 2021|Louisiana|

Massachusetts

The Massachusetts Department of Public Health has issued a new COVID19 Bulletin dealing with booster vaccine rollout.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

Erica Joyner2021-10-01T12:24:41-04:00October 1, 2021|Massachusetts|

Missouri

The Department of Social Services MO HealthNet issued a bulletin announcing the Medicaid prescription reimbursement will be increased on October 1, 2021. In-state pharmacy providers will continue to receive a professional dispensing fee of $12.22, plus an adjustment to account for the cost of the Missouri Pharmacy Reimbursement Allowance attributable to Medicaid-reimbursed prescriptions. The professional dispensing fee plus the current adjusted amount will total $12.70. Out-of-state pharmacy providers will continue to receive a professional dispensing fee of $8.85.

Also in Missouri, effective September 1, 2021, MO HealthNet (Medicaid) started paying for transportation for Medicaid fee-for-service patients with an appointment at a pharmacy to receive vaccinations.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Erica Joyner2021-10-01T12:22:49-04:00October 1, 2021|Missouri|

Nebraska

Effective October 1, all Medicaid beneficiaries will automatically receive full Medicaid benefits, including dental, vision and over-the-counter drugs as part of the Medicaid Expansion program. A new Medicaid card will not be needed for people who have current Medicaid coverage. Recall this change to the Medicaid Expansion program occurs as a result of the Department of Health and Human Services’ notice not to implement the Heritage Health Adult (HHS) demonstration that would have required engagement in wellness, personal responsibility and community engagement activities to quality for full Medicaid benefits.

Also in Nebraska, the Department of Health and Human Services (DHHS) announced the next weekly COVID-19 Medicaid Provider call will take place on October 6 at noon. Information to access the call has been posted on the DHHS website.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Erica Joyner2021-10-01T12:21:43-04:00October 1, 2021|Nebraska|

New York

The New York Health Commissioner approved the recommendations of the DUR Board developed at the July 2021 meeting. The meeting summary on the DOH website has been updated to include the Commissioner’s final determinations.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

Erica Joyner2021-10-01T12:20:26-04:00October 1, 2021|New York|

North Carolina

The North Carolina General Assembly has passed, and Governor Cooper has signed into law, legislation that authorizes qualified immunizing pharmacists to administer long-acting injectable medications to patients age 18 and older pursuant to prescription. This new authority becomes effective on October 1, 2021. Board staff has prepared a guidance document that summarizes the new authority and how pharmacists may exercise it.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Erica Joyner2021-10-01T12:19:38-04:00October 1, 2021|North Carolina|

Ohio

Earlier this year, the Ohio Department of Medicaid (ODM) announced the selection of seven managed care organizations (MCOs) who will partner with the Department to provide Medicaid Services. The seven MCOs are: AmeriHealth Caritas Ohio, Inc.; Anthem Blue Cross and Blue Shield; Buckeye Community Health Plan; CareSource Ohio, Inc.; Humana Health Plan of Ohio, Inc.; Molina Healthcare of Ohio, Inc; and UnitedHealthcare Community Plan of Ohio, Inc. Providers who are interested in contracting with them are encouraged to contact them. Contact information for the MCOs can be found on the Resources for Providers webpage of the next generation website.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Erica Joyner2021-10-01T12:18:34-04:00October 1, 2021|Ohio|

About Erica Joyner